Permit Pp a
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 - 00071
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/20/2009
PARCEL: 2 S 103 CA - 03200
SITE ADDRESS: 11535 SW TERRACE TRAILS DR ZONING: R-4.5
SUBDIVISION: TERRACE TRAILS LOT: 004 JURISDICTION: TIG
PROJECT: FORD
Project Description: Replace gas line for existing furnace and water heater.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 2
Owner: FEES
ROCKY & MARILYN FORD Description Date Amount
11535 SW TERRACE TRAILS
TIGARD, OR 97223 [MECH] Permit Fee 2/20/200c $72.50
[TAX] 12% State Surch 2/20/200c $8.70
Phone:
Total $81.20
Contractor:
PORTLAND MECHANICAL CONTRACTOR
2000 SE HANNA HARVESTER DR
MILWAUKIE, OR 97222 REQUIRED ITEMS AND REPORTS
Contact #: PR] 503- 656 -7400
FAX 503- 655 -0620
Reg #: LIC 151807
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 420 Permittee Signature: �1Xl . App IOa*«n
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
w2/19/2009 11:21 5036550620 PMC GROUP PAGE 02/03
Mechanical Permit Applicatio FOR OFFICE USE ONLY
City of Tigard E�E ear . • _ _i, Permit No.: '"` coq ' 0007
,
• 13125 SW Hall Blvd., Tigard, OR 972
i Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
p 598 FEB 19 2009
T 1
Date/By:
A R D Date
Inspection Line: 503.639.41 Ready/By: Fill el See Page 2 for
Internet: www.tigard- or.gov
Notified/Method: Supplemental Information
p ( I l �� yy _ ' OF TIGARD q �y{�� r �u
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r 1��..,:ialil =� I irlir�- 2 , "t "_'lal s: ' ��. �Il�i,llll�.rl �i ate.
N ew construction Mechanical permit fees" are based on the value of the work
El ® Addition /alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
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® 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
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❑ Multi - family 0 Master builder For special information use checklist.
❑ Other:
h! ll !ij n:u*I I I'( '_ j�j�r ,;r.,rx ,. Description I Qty. I Ea. I Total
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Ihnll'! II Iti �I I I I� ii,nls r , r 1, : � r -w �1 Sfil r,!'r75 -r°.z" ='f lull iiiiiiiii iLA: - ,Itii. Heating/cooling
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Air conditioning or heat pump
Job site address: 11535 SW Terrace Trails Drive (requires site plan showing placement) 14.00
City/ State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
•
Suite/bldg. /apt. no.: I Project name: Rocky Ford Gas heat pump 14.00
Cross street/directions to job sac: Duct work _ 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Flue/vent for any of above 6.80
Subdivision: I Lot no.: Other: 10.00
Tax map /parcel no.: Other fuel appliances
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1Np I� I I . a .... riP-J 1Y PII00 i'1!h 1 . Il
i I i 1 ; 7 I l i I 1 ,.., , i Water heater
Irr .� lf!h� II ,� _r I� Ir a ' 10.00
+!! U .r a w._.� o. ,�,.., a 1 ': •, li i�,rlrr� Gas fireplace 10.00
Relocate less than 50ft gas piping for NW Natural Gas. Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
u r rro . „� r, �„ , I „ ,;, r.w
Chimney/liner/flue/vent /liner /flue/ven
i•, l� 1 f � . i ll II,a - __ . .�� �, . ': ',::, eY t 10.00
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jbl.lfg IIuIII„m > _ ; 1 � I „r .x . ` N; �1:����1;Il11%rrk..... IT h, . , i'`'. ."_?i, ,,,! i Ili..r 1 ,
Other: 10.00
Name: Rocky & Marilyn Ford Environmental exhaust and ventilation
Range hood/other kitchen
Address: 11535 SW Terrace Trails Drive equipment 10.00
City/State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
I 'I i 111 'iL''19'.:^? u'° rl �� . { .�.....: � ; � . 1 j , n a.
:III {I .r�,l IiII' '1 -•c?It n,.' ' e Taff II; 1., . ; ,. f , �„ 1 {y1 ?t (�) f ''rii: ' 0.00
' S' I.i11111{I161 -. .. � l I. I .. ��'•r' " ll.,:� � :�I,i Iit�r!�l I:J Attic/crawlspace fans 1
I
Business name: Portland Mechanical Contractors
Other: 10.00
Fuel piping
Contact name: Kevin Miller $5.40 for first four; $1.00 for each additional
Address: 2000 SE Hanna Harvester Driv Furnace, etc. /
Gas heat pump
City/State/ZIP: Milwaukie, OR 97222 Wall /suspended/unit heater
Phone: (503) 656 -7400 I Fax: : (503) 655 - 0620 Water heater
Fireplace
E -mail: kevinm ®pmc -g.com _ Range
,�, rl }' $11i►iII 1! 1 I �. Y w� r, I . , r! m i,!1 f i ii Ci 1 i°ul•.r__- . .i . "iii'I I ��r..ee•Fa. :ciP Il g Barbecue
,�,.- r � . �...,: � rlr u� III.. �. �r. � �-, arfrr��i I l�i�rlir7 _r:��:ii�lfal�afl'I:I'1':�� ::;.��,N;�I!Ij
Business name: Same as above. Clothes dryer (gas)
_ Other: t-
Address: .- :~ 1 . ' Vntr 41 1 04 r iluhmui ,:, 0i Miljj,ilIF
City/ State/ZIP: Subtotal 72- I •
Phone: Minimum permit fee ($72.50)
( ) Fax: ( ) Plan review (25% of permit fee)
CCB lie.: 151807 State surcharge (12% of permit fee) g. 7 ('
TOTAL PERMIT FEE p • T C'�
Authorized signature TIiI permit appllcatlon expires if a permit Is not obteIne lthtn 180
- days after It has been accepted as complete.
Print name: Kevin Miller � r I Date: - • Fee methodology set by Tri -County Building Industry Service Board
: •. „ .
CITY OF TIGARD
BUILDING DIVISION
/ PERMIT #: MEC200!100071
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/2a0009
Phone: (503) 639-41 -- rlilt
Inspection Requests (24 Hrs.): (503) 639-4175 3.280- en.,
INSPECTION WORKSHEET FOR DATE: 2/25/2009 TIME: 7;00AM PAGE: 23
SITE ADDRESS: 11535 SW TERRACE WAILS DR CLASS OF WORK:
SUBDIVISION: TERRACE TRAILS LOT #: 004 TYPE OF USE:
PROJECT NAME: FORD
DESCRIPTION: Replece gas line lor e-, furnace : water heater.
OWNER: FORE), ROCKY & MARILYN PHONE #:
CONTRACTOR: PORTLAND MECHANICAL CONTRACTOR PHONE #: 603
Inspection Request Scheduled For: Date: 2/26/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
' my/Oki
699 Mechanical fa I 000799 01 603.049-7927
Vilt
;.*
Corrections/Comments/ Instructions:
—
( 0L t --- Gt-( f 0
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...-- )
--
PASS 0 PARTIAL APPROVAL - 0 CANCEL i 1 NO ACCESS
[ FAIL El CALL FOR INSPECTION 0 ADDITIONAL EES ASSESSED
414.,
4 :__
Inspector. . 1111k 7 Date: (5 Phone #: (503) 718- 2-- 3 C,,